Healthcare Provider Details

I. General information

NPI: 1043467335
Provider Name (Legal Business Name): ANN HA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17742 BEACH BLVD STE 360
HUNTINGTON BEACH CA
92647-6854
US

IV. Provider business mailing address

17742 BEACH BLVD. 360
HUNTINGTON BEACH CA
92647
US

V. Phone/Fax

Practice location:
  • Phone: 714-848-0868
  • Fax: 714-848-2248
Mailing address:
  • Phone: 714-848-0868
  • Fax: 714-848-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA110115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: